Public Health: A Very Short Introduction by Virginia Berridge

Author:Virginia Berridge
Language: eng
Format: epub
ISBN: 9780199688463
Publisher: OUP Oxford
Published: 2016-05-27T04:00:00+00:00

Local government services: a location for public health?

In the UK, World War I resulted in the Ministry of Health in 1919 and also in a patchwork of services for special groups and the beginnings of a service empire for public health doctors. The interwar years saw the public health profession at the peak of its professional and service influence. But this also brought dilemmas for public health which have relevance for contemporary debates about where it is best located. It has been argued that public health neglected a ‘community watchdog’ role in favour of a focus on running services during this period.

Educating the public had been a public health function since the 19th century, and this role expanded markedly in the interwar years. One significant new development was the role of national organizations in the field. In Britain, the Central Council for Health Education was established in 1927, based on the previous British Social Hygiene Council which had focused on venereal diseases. In Leicester in the English Midlands, the local government health committee began to hold health weeks in the 1920s. Posters and handbooks were distributed and there were film screenings. Doctors and nurses gave health talks and there were exhibitions and tea parties. A national health campaign in 1937 included talks, articles in the press, and a public meeting where the audience listened to a radio broadcast by the Prime Minister, Neville Chamberlain.

Public health doctors were also running a widening range of health services. The legislation of the 1870s, in particular the Act of 1875, had given public health control of clean water, sewerage, regulation of streets, highways, and new buildings, health of dwellings, removal of nuisances, inspection of food, suppression of diseases, sanitary burial, regulation of markets, and registration of sickness. Subsequent legislation made different diseases notifiable, required local authorities to supervise the regulation of midwives, established a medical service in schools administered by local government, and gave local authorities the power to provide welfare services for mothers and children and to provide clinics for tuberculosis and venereal disease. The culmination of this trend towards service development under the mantle of public health came with the Local Government Act of 1929, when local authorities were allowed to take over the medical services of the Poor Law. Public health doctors could find themselves in charge of the local hospital and thus also running a range of clinical services.

The profession itself later saw this period as a ‘golden age’ when it had great power and influence, and the return to local government which took place in England in 2012 was seen as ‘coming home’. Historians have been more mixed in their views. Some, writing in the 1980s, saw it as a wrong turn for public health. By taking on such a range of services without a clear idea of what public health was really about, the occupation made itself vulnerable and did not act to improve the health of the poorer sections of the population. Public health doctors were overstretched because of their role in curative health services.

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